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What Happens When Fillers Go Wrong?

By Dr Harris

Fillers, administered by an experienced doctor, are on the whole very safe. However, two kinds of issues may arise – firstly undesirable or unnatural results, such as the dreaded ‘trout pout’, and secondly the very rare but serious complication – vascular occlusion, which is the unintended blocking of a blood vessel.

In both cases, Hyaluronidase (Hyalase) is used to dissolve the filler. More on that later. First, a bit about the all too common trout pout and the very rare vascular occlusion:

Trout pout

The overly filled lips, or puffy cheekbones and cartoonish look that can result from the work of an inexperienced practitioner are every woman’s nightmare.

In these cases, Hyalase can be used to reverse these unnatural results and works to break down the product very quickly – usually over a 24-48 hour period. A corrective procedure with fillers to restore a more natural looking effect may then be done after a five day period.

And even where the results aren’t so extreme, whenever a client is unhappy with the result of a filler treatment, Hyalase can be used to reverse it.

Vascular occlusion

The blocking of a blood vessel, although always unintended, can happen and left untreated can have serious consequences.

In such cases, Hyalase can be administered repeatedly to dissolve the filler and restore normal functioning in the area. When deciding on a procedure, it is therefore imperative that your practitioner know how to deal with complications, especially when dissolving is required.

What is Hyalase?

Hyaluronidase – or Hyalase – is an enzyme that catalyses the degradation of hyaluronic acid (HA). It is often used in conjunction with other drugs to speed their dispersion and delivery, for example in ophthalmic (eye) surgery, in combination with local anaesthetics. In Aesthetic Medicine, Hyalase is commonly used to reverse complications and undesirable aesthetic results involving HA fillers such as Juvederm.

It comes in powder form which is mixed with the correct amount of saline solution before being injecting directly into the target area.

Are there side effects?

Use of Hyalase does mean that some of your own naturally occurring HA will dissolve too. However the body replaces its own stores of HA every few days.

Other common side effects include bruising and swelling, but these disappear within days. Allergic reactions are rare, but a ‘patch test’ (involving injection of a small amount just under the skin of the forearm) is recommended for at least 20 minutes before use.